ArticleThe Journal of arthroplasty2020
Tranexamic Acid Does Not Reduce the Risk of Transfusion in Rheumatoid Arthritis Patients Undergoing Total Joint Arthroplasty.
Article in The Journal of arthroplasty, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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13 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Routine pretransfusion testing before primary total hip or knee arthroplasty are an expensive and wasteful routine. Systematic review and meta-analysis.Archives of orthopaedic and trauma surgery · 2024Pooled it
- Multiple intravenous tranexamic acid doses in total knee arthroplasty in patients with rheumatoid arthritis: a randomized controlled study.BMC musculoskeletal disorders · 2021Trial
- Impact of rheumatoid arthritis on complications and hospital outcomes following reverse shoulder arthroplasty: evidence from 389,135 hospitalizations in the national inpatient sample.Archives of orthopaedic and trauma surgery · 2026Article
- Impact of Anemia on Outcomes Following Total Hip Replacement Surgery and Patient Prognosis.Orthopaedic surgery · 2026Review
- Patient characteristics and adverse effects of allogeneic blood transfusion following lower extremity joint replacement in rheumatoid arthritis: a nationwide inpatient sample database study.BMC rheumatology · 2025Article
- Effect of tranexamic acid on blood loss during THR in patients with inflammatory versus degenerative hip arthritis: A retrospective cohort study.Journal of clinical orthopaedics and trauma · 2025Article
- Comparison of blood loss between intra-articular microporous polysaccharide hemospheres powder and tranexamic acid following primary total knee arthroplasty.Scientific reports · 2024Article
- The efficacy and safety of tranexamic acid in rheumatoid arthritis patients undergoing simultaneous bilateral total knee arthroplasty: a multicenter retrospective study.BMC musculoskeletal disorders · 2023Article
- More complications and higher transfusion rate in patients with rheumatoid arthritis than osteoarthritis undergoing total hip arthroplasty.International orthopaedics · 2023Article
- Predisposing factors for allogeneic blood transfusion in patients with rheumatoid arthritis undergoing primary unilateral total knee arthroplasty.Frontiers in surgery · 2023Article
- Total Knee Arthroplasty in Patients with Primary Sjögren's Syndrome: A Retrospective Case-Control Study Matched Patients without Rheumatic Diseases.Journal of clinical medicine · 2022Article
- Article
- Factors Associated With Increasing Length of Stay for Rheumatoid Arthritis Patients Undergoing Total Hip Arthroplasty and Total Knee Arthroplasty.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2022Article
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11 authors at 2 institutions in 1 country.
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Abstract
backgroundPatients with rheumatoid arthritis (RA) receive transfusions more often than patients with osteoarthritis following lower extremity total joint arthroplasty (TJA), but mitigating factors are not described. Tranexamic acid (TXA) is widely used to reduce blood loss in patients undergoing TJA, but its effect on transfusion rates in patients with RA has not been studied.
methodsWe retrospectively reviewed data from a prospectively collected cohort of patients with RA undergoing TJA. Disease activity measured by Clinical Disease Activity Index, patient-reported outcome measures, and serologies was obtained. Baseline characteristics were summarized and compared. Transfusion requirements and TXA usage were obtained from chart review. Logistic regression was used to determine factors associated with transfusion in RA patients undergoing TJA.
resultsThe cohort included 252 patients, mostly women with longstanding RA and end-stage arthritis requiring TJA. In multivariate analysis, 1 g/dL decrease in baseline hemoglobin (odds ratio [OR] = 0.394, 95% confidence interval [CI] [0.232, 0.669], P = .001), 1-minute increase in surgical duration (OR = 1.022, 95% CI [1.008, 1.037], P = .003), and 1-point increase in Clinical Disease Activity Index (OR = 1.079, 95% CI [1.001, 1.162]) were associated with increased risk of transfusion. TXA use was not associated with decreased risk of postoperative transfusion.
conclusionsPreoperative health optimization should include assessment and treatment of anemia in RA patients before TJA, as preoperative hemoglobin level is the main risk factor for postoperative transfusion. Increased disease activity and increased surgical time were independent risk factors for postoperative transfusion but are less modifiable. While TXA did not decrease transfusion risk in this population, a prospective trial is needed to confirm this. LEVEL OF EVIDENCE: IV.
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